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General NPI Number Information
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NPI Number | 1871027946
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Entity Type | Individual
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Provider Name | TIFFANY MEGAN LAU MD
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Gender | Female
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Dates
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Enumeration Date | 04/17/2017
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 3840 ATMORE GROVE DR
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City | LUTZ
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State | FL
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Zip | 33548-7903
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Country | US
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Telephone | 813-607-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 1937 SWEETBROOM CIR APT 302
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City | LUTZ
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State | FL
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Zip | 33559-8741
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Country | US
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Telephone | 316-554-6064
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME150475
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License Number State | FL
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